Date of Submission

2003

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Arthur Freeman, Ed.D., ABPP

First Advisor

Barbara A. Golden, Psy.D., Chairperson

Second Advisor

Robert A. DiTomasso, Ph.D., ABPP

Third Advisor

Meryll E. Udell, Ph.D.

Abstract

This study retrospectively reviewed 765 patients who presented within a one-year period at either a suburban, urban, or both suburban and urban psychiatric emergency services (PES). Demographic and clinical characteristics were examined. Particular focus included characteristics of children/adolescents and older adults, as well as the relationship between substance misuse and PES presenters. Adults presenting to PES more than three times were more likely to have a chronic mental illness, personality disorder, history of psychiatric treatment, and a history of noncompliance with treatment than those who presented three times or less. Significant differences were found between urban and suburban PESs, in that adults presenting to only the suburban PES were more likely to be employed. Children/adolescents who presented to PES multiple times were more likely to have a history of psychiatric treatment than children/adolescents who had presented one time. No significant differences that were predicted were found between older adults who presented to PES multiple times and older adults who presented to PES one time. Adults who re-presented to PES within 30 days of being discharged from PES were less likely to have social and economic problems. Adults with comorbid diagnosis of substance abuse and psychosis were more likely to visit PES more than one time within a year. Adults who presented to PES with a diagnosis of primary substance abuse without a chronic mental illness were more likely to be self-referred and discharged to the community.

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